Wednesday, June 1, 2016

Another ER milestone

Well guys, it finally happened - after many years, I finally got caught by a family member for shaming a patient about their visit. It was bound to happen eventually. But before you get on my case about being rude or mean, hear me out.

I had a guy come in for a ridiculous reason. Like, even the standalone clinic would triage him an ESI 5 and roll their eyes. To make matters worse, he was also a middle aged guy who brought his mom with him so she could be his mouth and ask for pain medication for him and also relay his medical history to the doctor. Sidenote here, the only time it's appropriate for the mother of a grown ass patient to be speaking for their child is if the chief complaint reads "my mouth fell off and now I can't talk." But anyway, I went in to do my assessment and tell them that it was a super busy night so expect to be waiting for a while. The mother asks me if I can give him pain medication, and I explain that I can't give anything until the doctor sees them, which again, might be a while. Five minutes later she's back up at the desk to ask again, and I explain through the entire process a second time. And I shit you not, but five minutes after that she's up again to ask.

Right then another nurse steps out into the hallway from the room next to mine, with a look of...not panic, but severe alarm on her face. I excuse myself from my patient's mother and step in to help with this guy who EMS just dropped off and HOLY SHIT IS IN VTACH RIGHT NOW. He looks like absolute garbage even though he's got a pulse and is awake and talking, so she starts triaging while the tech grabs an EKG and I drop an IV and grab the ACLS box full of fun medications. We get the guy moved over to a critical bed, and while hooking him back up to the new rooms' monitor and pads, another nurse pokes her head into the room and says, "hey, do you have room 43? His mother is out here asking if he can have pain medication?" I super bluntly just said "yeah, he's here for a hangnail*. He's gonna have to wait."

Long story short, she overheard me say that and got super upset. In the past, I probably would have been super apologetic and attempted to get the doc in their room quicker, but now I just doubled down and told the patient and mother to their faces that actual emergencies get taken care of first in an emergency room. They were super mad, asked to speak to the charge nurse, who told them the exact same thing. Then they eloped from the department with the promise "to come back again in the morning when someone here will actually help my son!**"


*Not the real chief complaint, but I couldn't think of a generic enough absurd minor one so as not to violate HIPAA.

**They came back eight hours later, sat forever in the waiting room because it was the day after a holiday, and then got discharged immediately without pain medication. It was awesome.


Shash said...

Oh yay. Good for you and your charge nurse. AND whoever saw Mommy and Boo-Boo boy the next day.

Guera Enfermera said...

Ugh... I work in prison, and just yesterday had a (young, healthy, no prior hx) gentleman cause an emergency response 10 minutes before clock out time for a c/o "fell off bunk" and "knee dislocation"
We're only staffed in medical from 6a-615p, so dude was trying to wait for us to leave so he could get an automatic ER trip/some D medicine. Fail, sir.

Y'all in the ER are far hardier souls than I, for sure. My hat is off to you!

Guera Enfermera said...

I accidentally omitted the fact that his dislocation was actually him externally rotating his hip to give that impression to the non-medical officers.
Shit didn't fly with our pint sized little lioness of an awesome Doc, who promptly kicked him out of the clinic for cussing at her. He exited with nary a limp, btw.

girlvet said...

This is the story of our lives. When mommy or wifey talks for what is usually a male, I tell them I need to hear from the patient. Often they don't like it. Oh well..

I understand what you are saying about not backing down. If you have worked in the ER for any length of time, you will get a patient who "wants another nurse". Used to worry, now I tell them they won't get another nurse, I'm it, get used to it. I'm sick and tired of these rude people.